Tonsillitis with Acute Myeloid Leukemia: A Case Series for Caution

2013 ◽  
Vol 92 (4) ◽  
pp. E22-E23 ◽  
Author(s):  
Jagdeep S. Thakur ◽  
N.K. Mohindroo ◽  
D.R. Sharma ◽  
Shobha Mohindroo ◽  
Anamika Thakur
Keyword(s):  
Acute Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Case Series ◽  
Acute Myeloid

scholarly journals Experiences with next-generation sequencing in relapsed acute myeloid leukemia: a patient case series

2020 ◽  
Vol 12 (1) ◽  
pp. e2020068
Author(s):  
Johanna Flach ◽  
Evgenii Shumilov ◽  
Naomi Porret ◽  
Inna Shakhanova ◽  
Myriam Legros ◽  
...  
Keyword(s):  
Acute Myeloid Leukemia ◽  
Next Generation Sequencing ◽  
Myeloid Leukemia ◽  
Case Series ◽  
Next Generation ◽  
Patient Case ◽  
Generation Sequencing ◽  
Relapsed Acute Myeloid Leukemia ◽  
Acute Myeloid

Not applicable

scholarly journals Acute Myeloid Leukemia in Patients Living with HIV Infection: Several Questions, Fewer Answers

2020 ◽  
Vol 21 (3) ◽  
pp. 1081
Author(s):  
Fabio Forghieri ◽  
Vincenzo Nasillo ◽  
Francesca Bettelli ◽  
Valeria Pioli ◽  
Davide Giusti ◽  
...  
Keyword(s):  
Acute Myeloid Leukemia ◽  
Hiv Infection ◽  
Myeloid Leukemia ◽  
Case Reports ◽  
Case Series ◽  
People Living With Hiv ◽  
Hematopoietic Stem ◽  
Molecular Features ◽  
Living With Hiv ◽  
Acute Myeloid

Both human immunodeficiency virus (HIV) infection and acute myeloid leukemia (AML) may be considered relatively uncommon disorders in the general population, but the precise incidence of AML in people living with HIV infection (PLWH) is uncertain. However, life expectancy of newly infected HIV-positive patients receiving anti-retroviral therapy (ART) is gradually increasing, rivaling that of age-matched HIV-negative individuals, so that the occurrence of AML is also expected to progressively increase. Even if HIV is not reported to be directly mutagenic, several indirect leukemogenic mechanisms, mainly based on bone marrow microenvironment disruption, have been proposed. Despite a well-controlled HIV infection under ART should no longer be considered per se a contraindication to intensive chemotherapeutic approaches, including allogeneic hematopoietic stem cell transplantation, in selected fit patients with AML, survival outcomes are still generally unsatisfactory. We discussed several controversial issues about pathogenesis and clinical management of AML in PLWH, but few evidence-based answers may currently be provided, due to the limited number of cases reported in the literature, mainly as case reports or small retrospective case series. Prospective multicenter clinical trials are warranted to more precisely investigate epidemiology and cytogenetic/molecular features of AML in PLWH, but also to standardize and further improve its therapeutic management.

Synchronous detection of multiple myeloma and acute myeloid leukemia: A diagnostic and therapeutic challenge

2020 ◽  
pp. 107815522093235
Author(s):  
Senem Maral ◽  
Murat Albayrak ◽  
Osman Sahin ◽  
Hacer Berna Afacan Ozturk ◽  
Unsal Han ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Acute Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Skin Infection ◽  
Plasma Cells ◽  
Treatment Strategies ◽  
Case Series ◽  
Synchronous Detection ◽  
Reactive Plasmacytosis ◽  
Acute Myeloid

Introduction Synchronous detection of multiple myeloma and acute myeloid leukemia in a single patient is a rare coincidence. Treatment of these patients is still unclear, mostly based on acute myeloid leukemia strategies combined with bortezomib. Case report A 72-year-old male with no medical history was investigated for pancytopenia. On medical examination, he was complicated with a wide and severe skin infection on arm. On examination of bone marrow aspirate, 25% myeloblasts infiltration and additional 10% plasma cells were seen. Acute myeloid leukemia was diagnosed and plasma cell proliferation was attributed to reactive plasmacytosis due to skin infection. However, flowcytometric studies and immunohistochemical examination revealed two different cell populations with 30–40% atypical plasma cells and >20% myeloblasts. Serum M-protein detected by serum electrophoresis test and immunofixation test revealed a monoclonal IgG lambda band. He was diagnosed with concurrent acute myeloid leukemia and multiple myeloma without history of chemotherapy. Management and outcome: The patient was initially treated with bortezomib and dexamethasone for the myeloma. Subsequently, azacitidine was administered subcutaneously for the acute myeloid leukemia treatment. The tru-cut biopsy of the lesion on his arm revealed suppurative inflammatory findings and no malign cells detected. Antibiotherapy was started according to susceptibility. He expired after three months of survival. Discussion The synchronous occurrence of these two different clonal hematological malignancies is rare in hematology practice. Patient-based prospective studies and case series are needed to guide diagnosis and treatment strategies. Furthermore, this report highlights the importance of ruling out reactive plasmacytosis in patients with hematological malignancy who developed severe infections.

scholarly journals Hemophagocytic lymphohistiocytosis as an unexpected complication of Venetoclax+Azacitidine in Acute Myeloid Leukemia

2021 ◽  
Vol 9 (1) ◽  
pp. 17-19
Author(s):  
Ovilla-Martinez Roberto ◽  
Perez-Lozano Uendy ◽  
Cota-Rangel Xochitl ◽  
Baez-Islas Pamela
Keyword(s):  
Acute Myeloid Leukemia ◽  
Hemophagocytic Lymphohistiocytosis ◽  
Myeloid Leukemia ◽  
Early Recognition ◽  
Case Series ◽  
Lymphocytic Leukemia ◽  
Acute Phase Reactants ◽  
Hematologic Disorder ◽  
Serious Infections ◽  
Acute Myeloid

Background: Venetoclax is a drug that targets BCL-2 protein in cancer cells, first approved for chronic lymphocytic leukemia, this drug has showed efficacy also in acute myeloid leukemia in non-intense chemotherapy candidates in combination with hypomethylating agents as azacitidine and decitabine. This scheme has shown efficiency in acute myeloid leukemia reporting overall response rate (CR) in 61% in untreated elderly patients combined with azacitidine or decitabine. Febrile neutropenia was reported in 30%, thrombocytopenia in 47%, and serious infections in 33%. Hemophagocytic lymphohistiocytosis (HLH) is an uncommon hematologic disorder caused by a proinflammatory state manifested by cytopenias and elevation of acute phase reactants; it is a severe complication of some diseases and to our knowledge it has never been reported secondary to venetoclax plus azacitidine. Early treatment is fundamental for success in HLH. Case series: Three cases of HLH secondary to venetoclax plus azacitidine have appeared in our medical group in patients treated for acute myeloid leukemia. One elderly woman and elderly men with previously untreated acute myeloid leukemia presented HLH with laboratory and bone marrow findings, both responded to dexamethasone plus ruxolitinib. The third case was documented in a male diagnosed with blast phase chronic myeloid leukemia who also responded to dexamethasone plus ruxolitinib. No patient died from HLH. Conclusion: Here we report three cases of patients with HLH after the treatment with azacitidine plus venetoclax. We suspect that the great effect of venetoclax in synergy with azacitidine can liberate enough proinflammatory cytokines in the medullar niche to induce HLH. Early recognition is vital for soon treatment and successful management of this potential complication.

scholarly journals Adult Case Series of Extramedullary Relapsing Acute Myeloid Leukemia (AML) after Allogeneic Stem Cell Transplantation in Whom a Rapid Response and a Reasonably Long Remission Could be Achieved with Gemtuzumab Ozogamycin (GO)

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 5129-5129
Author(s):  
Omur Gokmen Sevindik ◽  
Ali Ihsan Gemici ◽  
Furkan Selim Usta ◽  
Asli Çakır ◽  
Sevil Sadri ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Acute Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Case Series ◽  
Skin Lesions ◽  
Salvage Chemotherapy ◽  
High Dose ◽  
Extramedullary Disease ◽  
Blast Count ◽  
Acute Myeloid

Gemtuzumab Ozogamycin (GO) is a drug conjugated monoclonal antibody which targets CD33 an antigen highly expressed on the surface of AML blasts. GO is approved for the treatment of both newly-diagnosed and relapsed AML. Despite growing evidence regarding its efficacy and safety among AML patients there is limited data about the use of GO in isolated extra-medullary relapsed AML. Extramedullary AML remains as an unmet clinical need regarding the poor prognosis and lack of a standard therapeutic approach. Our cases demonstrated a rapid and long lasting response with a favorable toxicity profile, in patients who were treated with GO as a single agent after an isolated extramedullary relapsing disease. Our first case was a 40-years-old woman admitted to our outpatient clinic with pain in her joints and redness in her back and stomach. She was diagnosed with CD33-positive Acute Myeloid Leukemia according to the immunophenotyping of bone marrow blasts. Idarubicin and ARA-C (7+3) combination initiated as a frontline induction therapy and morphological remission was achieved after the first cycle of induction. After the first cycle of consolidation chemotherapy with high dose ARA-C she has relapsed with skin myeloid sarcomas and diffuse bone marrow infiltration. Soon after the relapsing disease she was put on to ida-flag salvage chemotherapy and she responded well with the disappearance of skin lesions and morphological complete remission of bone marrow. After achieving response, an allogeneic stem cell transplantation (HSCT) was applied from her sibling donor with a myeloablative conditioning. Unfortunately patient had a relapsing extramedullary disease with reappearance of skin lesions even with an ongoing acute skin gvhd (Figure) soon after allogeneic HSCT. Bone marrow biopsy revealed no increase in blast count. We have decided to initiate a novel targetted therapy to control the extramedullary disease. As her blasts infiltrating the skin were universally CD 33 positive we considered to put her on GO therapy with the approval obtained from health authority. GO was applied according to the dosage approved by FDA for relapsing disease. After the first cycle of GO she had a rapid disappearance of all skin lesions just complicated with a febrile neutropenic episode and re-activation of CMV infection which was controlled with Gancyclovir. She has retained a complete remission regarding extramedullary disease throughout the repeated courses of GO for 3 times, and she is still in remission for 4 months after the first appearance of skin lesions (Figure). Our second case was a 24-years-old boy who admitted to our outpatient clinic with a worsening fatigue and shortness of breath. He was also diagnosed with CD33-positive Acute Myeloid Leukemia according to the immunophenotyping of bone marrow blasts and was able to achieve a morphological CR after frontline induction therapy with 7+3 protocol. After two cycles of high dose ARA-C consolidation he was transplanted from a matched unrelated donor because of an intermediate cytogenetic risk profile. At the 14th month of allogeneic transplantation he had relapsed with a bone marrow blast count of 90% and harboring a monosomy on the 10th chromosome. After the first salvage chemotherapy with IDA-FLAG protocol he has achieved a morphological CR and we have decided to proceed with an alternative donor transplantation. But unfortunately soon after discharge, he has admitted to the emergency clinic with a new onset headache and nausea and vomiting. A cranial CT revealed multiple foci of solid masses with peripheral edema. We have performed a lumbar puncture and CSF fluid revealed a high number of CD33 positive blastic cells (over 100 cells per HPF). At the time of central nervous system (CNS) relapse his bone marrow was free of blastic infiltration. We decided to initiate GO treatment with the diagnosis of isolated central nervous system relapse of AML, accompanying intra-thecal chemotherapy via an Omaya Reservoir. He has received two cycles of GO which was complicated with neutropenic fever and grade 4 leukopenia and thrombocytopenia, and his CNS lesions also responded well and clinically he had no CNS related signs or symptoms. The patient received additional GO with continued response but unfortunately after a severe pneumonia he passed away at intensive care unit. Our case series documented a clinically relevant therapeutic field for GO in isolated extramedullary relapse of AML. Disclosures No relevant conflicts of interest to declare.

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